[Consequences of new patient discharge guidelines on the cost structure of radioiodine therapy].
OBJECTIVE
Consequences of the new recommendations by the Federal German Radiation Protection Committee (SSK) for patient discharge guidelines (residual activity of 250 MBq for I-131) were calculated for duration of stay and radioiodine therapy cost management.


METHODS
For 601 consecutively admitted patients with hyperthyreosis, actual duration of stay and duration of stay according to previous guidelines (from 1993) were calculated, as well as duration of stay according to recommended values. Following BPflV statutes, cost-analysis considered the cause and volume of goitre, and by using sensitivity analyses included a range of diagnostics, service assessment, and duration of stay.


RESULTS
Duration of stay following I-131 therapy (in Germany) is expected to fall by 35-50% (average future stay 4.0 +/- 2.8 days), average costs from DM 4,452 to DM 3,680 (-17.4%). Not including pretreatment diagnostics, cost reduction (service assessment 17-24%) was estimated at 21-25%. Compared to strumectomy, I-131 therapy costs are expected to be lower for goitres (Graves' disease) up to at least 60 ml, toxic nodules of at least 25 ml, and toxic multinodular goitres of at least 90 ml.


CONCLUSIONS
In the future, I-131 therapy will be more cost-effective even with larger goitres. Since reimbursement is determined by the duration of stay, new reimbursement procedures are discussed in this paper.
Dietlein
M
M
Klinik und Poliklinik für Nuklearmedizin, Universität zu Köln, Deutschland.
Troche
C J
CJ
Moka
D
D
Bausch
V
V
Lauterbach
K W
KW
Schicha
H
H
D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005500:Follow-Up Studies; D005858:Germany; D006111:Graves Disease / Q000191:economics / Q000532:radiotherapy; D006801:Humans; D006980:Hyperthyroidism / Q000191:economics / Q000532:radiotherapy*; D007457:Iodine Radioisotopes / Q000191:economics* / Q000627:therapeutic use; D007902:Length of Stay; D010351:Patient Discharge / Q000191:economics*; D017410:Practice Guidelines as Topic; D019275:Radiopharmaceuticals / Q000191:economics* / Q000633:toxicity; D012680:Sensitivity and Specificity
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals
Auswirkungen der neuen Entlassungsrichtwerte auf die Kostenstruktur der Radioiodtherapie.